Role: Credentialing Specialist

Fully Remote Opportunity

1-year Contract

Pay rate: $15/hr on W2 Health Insurance

Project Break Down

• Screens provider credentialing and re-credentialing packets for missing information; requests missing information from the provider; resolves discrepancies between information supplied and findings of other sources (State Dental, etc.)
• Creates and updates provider information in the credentialing system to ensure that credentials are completed within a timely manner and at a high level of accuracy
• Receives provider inquiries via phone and correspondence. Researches and verifies detailed information on provider participation status. Perform verification of all applicable credentials.
• Contact providers for missing and expired information.
• Processing mail; incoming and outgoing.
• Performs miscellaneous duties as assigned.

Skills/Experience

• A minimum of 2 years related experience.
• Knowledge of Delta Dental products, policies, and terms of provider participation in various networks is expected at conclusion of training and any applicable probationary period.
• Ability to maintain confidentiality of providers information.
• Demonstrated understanding of basic corporate structures and how to accurately translate information provided on contracts, credentialing attestations and other sources to maintain provider records.
• Math skills to compile and validate statistical computations, reconcile discrepancies, and ensure the validity and accuracy of results.
• Knowledge and application of English grammar including composition, editing and proofreading skills.
• PC literacy; MS Office skills (competency in Word, advanced skill in Excel, Access and other database applications).
• Regularly required to work standard office equipment (personal computer, photocopy machine, fax machine, etc.).